Cervical Hydatidiform Moles Pregnancy: Diagnosis and Treatment

Authors

  • I Gede Sastra Winata Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
  • Popy Kusuardiyanto Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
  • Made Bagus Dwi Aryana Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
  • Ryan Mulyana Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.7562

Keywords:

Partial cervical hydatidiform mole, Blighted ovum, Pregnancy, Diagnosis, Therapy

Abstract

Cervical partial hydatidiform mole is a rare condition and difficult to diagnose. A 39-year-old Balinese woman from Sanglah General Hospital, Bali, Indonesia complained vaginal bleeding with abdominal pain. The patient was diagnosed with a partial hydatidiform mole based on physical examination, ultrasound, beta HCG levels and pathology examinations. Mass evacuation surgery followed by arterial ligation to stop the bleeding and periodically examination of beta HCG levels was carried out until the 14th week after the procedure. Beta HCG decreased gradually to normal level and indicate no risk of trophoblastic malignancy. Establishing the early diagnosis significantly affects the outcome of patient.

Keywords: partial cervical hydatidiform mole, blighted ovum, pregnancy, diagnosis, therapy.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Hui P, Buza N, Murphy KM, Rennett BM. Hydatidiform moles: Genetic basis and precision diagnosis. Annu Rev Pathol. 2017;12:449-85. https://doi.org/10.1146/annurev-pathol-052016-100237 PMid:28135560 DOI: https://doi.org/10.1146/annurev-pathol-052016-100237

Salehi S, Eloranta S, Johansson AL, Bergstrom M, Lambe M. Reporting and incidence trends of hydatidiform mole in Sweden 1973-2004. Acta Oncol. 2011;50(3):367-72. https://doi.org/10.3109/0284186X.2010.512922 PMid:21395467 DOI: https://doi.org/10.3109/0284186X.2010.512922

Dhanda S, Ramani S, Thakur M. Gestational trophoblastic disease: A multimodality imaging approach with impact on diagnosis and management. Radiol Res Pract. 2014;2014:842751. https://doi.org/10.1155/2014/842751 PMid:25126425 DOI: https://doi.org/10.1155/2014/842751

Allen SD, Lim AK, Seckl MJ, Blunt DM, Mitchell AW. Radiology of gestational trophoblastic neoplasia. Clin Radiol. 2006;61(4):301-13. https://doi.org/10.1016/j.crad.2005.12.003 PMid:16546459 DOI: https://doi.org/10.1016/j.crad.2005.12.003

Elsayes KM, Trout AT, Friedkin AM, Liu PS, Bude RO, Platt JF, et al. Imaging of the placenta: A multimodality pictorial review. Radiographics. 2009;29(5):1371-91. https://doi.org/10.1148/rg.295085242 PMid:19755601 DOI: https://doi.org/10.1148/rg.295085242

Jain KA. Gestational trophoblastic disease: Pictorial review. Ultrasound Q. 2005;21(4):245-53. https://doi.org/10.1097/01.ruq.0000191658.95192.89 PMid:16344728 DOI: https://doi.org/10.1097/01.ruq.0000191658.95192.89

Sebire NJ, Seckle MJ. Gestational trophoblastic disease: Current management of hydatidiform mole. BMJ. 2008;337:a1193. https://doi.org/10.1136/bmj.a1193 PMid:18708429 DOI: https://doi.org/10.1136/bmj.a1193

Hui P, Baergen R, Cheung A, Fukunaga M, Gersell D, Lage JM, et al. Gestational trophoblastic disease. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH, editors. WHO Classification of Tumours of Female Reproductive Organs. Vol. 6. Geneva: World Health Organization; 2014. p. 155-67.

Sebire NJ, Foskett M, Fisher RA, Rees H, Seckl M, Newlands E. Risk of partial and complete hydatidiform molar pregnancy in relation to maternal age. BJOG. 2002;109(1):99-102. https://doi.org/10.1111/j.1471-0528.2002.t01-1-01037.x PMid:11843379 DOI: https://doi.org/10.1111/j.1471-0528.2002.t01-1-01037.x

Eagles N, Sebire NJ, Short D, Savage PM, Seckl MJ, Fisher RA. Risk of recurrent molar pregnancies following complete and partial hydatidiform moles. Hum Reprod. 2015;30(9):2055-63. https://doi.org/10.1093/humrep/dev169 PMid:26202916 DOI: https://doi.org/10.1093/humrep/dev169

Murdoch S, Djuric U, Mazhar B, Seoud M, Khan R, Kuick R, et al. Mutations in NALP7 cause recurrent hydatidiform moles and reproductive wastage in humans. Nat Genet. 2006;38(3):300-2. https://doi.org/10.1038/ng1740 PMid:16462743 DOI: https://doi.org/10.1038/ng1740

Qian J, Deveault C, Bagga R, Xie X, Slim R. Women heterozygous for NALP7/NLRP7 mutations are at risk for reproductive wastage: Report of two novel mutations. Hum Mutat. 2007;28(7):741. https://doi.org/10.1002/humu.9498 PMid:17579354 DOI: https://doi.org/10.1002/humu.9498

Kou YC, Shao L, Peng HH, Rosetta R, del Gaudio D, Wagner AF, et al. A recurrent intragenic genomic duplication, other novel mutations in NLRP7 and imprinting defects in recurrent biparental hydatidiform moles. Mol Hum Reprod 2008;14(1):33-40. https://doi.org/10.1093/molehr/gam079 PMid:18039680 DOI: https://doi.org/10.1093/molehr/gam079

Williams D, Hodgetts V, Gupta J. Recurrent hydatidiform moles. Eur J Obstet Gynecol Reprod Biol. 2010;150(1):3-7. https://doi.org/10.1016/j.ejogrb.2010.01.003 PMid:20171777 DOI: https://doi.org/10.1016/j.ejogrb.2010.01.003

Parry DA, Logan CV, Hayward BE, Shires M, Landolsi H, Diggle C, et al. Mutations causing familial biparental hydatidiform mole implicate C6orf221 as a possible regulator of genomic imprinting in the human oocyte. Am J Hum Genet. 2011;89(3):451-58. https://doi.org/10.1016/j.ajhg.2011.08.002 PMid:21885028 DOI: https://doi.org/10.1016/j.ajhg.2011.08.002

Reddy R, Akoury E, Nguyen NM, Abdul-Rahman OA, Dery C, Gupta N, et al. Report of four new patients with proteintruncating mutations in C6orf221/KHDC3L and colocalization with NLRP7. Eur J Hum Genet. 2013;21(9):957-64. https://doi.org/10.1038/ejhg.2012.274 PMid:23232697 DOI: https://doi.org/10.1038/ejhg.2012.274

Aytan H, Caliskan AC, Demirturk F, Koseoglu RD, Acu B. Cervical partial hydatidiform molar pregnancy. Gynecol Obstet Invest. 2008;66(2):142-4. https://doi.org/10.1159/000141647 PMid:18583920 DOI: https://doi.org/10.1159/000141647

Betel C, Atri M, Arenson A, Khalifa M, Osborne R, Tomlinson G. Sonographic diagnosis of gestational trophoblastic disease and comparison with retained products of conception. J Ultrasound Med. 2006;25(8):985-93. https://doi.org/10.7863/jum.2006.25.8.985 PMid:16870892 DOI: https://doi.org/10.7863/jum.2006.25.8.985

Schwentner L, Schmitt W, Bartusek G, Kreienberg B, Herr D. Cervical hydatidiform mole pregnancy after missed abortion presenting with severe vaginal bleeding: Case report and review of the literature. Eur J Obstet Gynecol Reprod Biol. 2011;156(1):9-11. https://doi.org/10.1016/j.ejogrb.2010.12.029 PMid:21272989 DOI: https://doi.org/10.1016/j.ejogrb.2010.12.029

Hancock BW. Staging and classification of gestational trophoblastic disease. Best Pract Res Clin Obstet Gynaecol. 2003;17(6):869-83. https://doi.org/10.1016/s1521-6934(03)00073-7 PMid:14614886 DOI: https://doi.org/10.1016/S1521-6934(03)00073-7

Kani KK, Lee JH, Dighe M, Moshiri M, Kolokythas O, Dubinsky T. Gestatational trophoblastic disease: Multimodality imaging assessment with special emphasis on spectrum of abnormalities and value of imaging in staging and management of disease. Curr Probl Diagn Radiol. 2012;41(1):1-10. https://doi.org/10.1067/j.cpradiol.2011.06.002 PMid:22085657 DOI: https://doi.org/10.1067/j.cpradiol.2011.06.002

Royal College of Obstetricians and Gynaecologists (RCOG). The Management of Gestational Trophoblastic Disease, Green-Top Guideline No. 38. United Kingdom: Royal College of Obstetricians and Gynaecologists; 2010. p. 1-12.

Kung FT, Chang SY, Tsai YC, Hwang FR, Hsu TY, Soong YK. Subsequent reproduction and obstetric outcome after methotrexate treatment of cervical pregnancy: A review of original literature and collaborative follow up. Hum Reprod. 1997;12(3):591-5. https://doi.org/10.1093/humrep/12.3.591 PMid:9130765 DOI: https://doi.org/10.1093/humrep/12.3.591

Ginsburg ES, Frates MC, Rein MS, Fox JH, Hornstein MD, Friedman AJ. Early diagnosis and treatment of cervical pregnancy in an in vitro fertilization program. Fertil Steril. 1994;61(5):966-96. https://doi.org/10.1016/s0015-0282(16)56714-4 PMid:8174738 DOI: https://doi.org/10.1016/S0015-0282(16)56714-4

Wee HY, Tay EH, Soong Y, Loh SF. Cervical hydatidiform molar pregnancy. Aust N Z J Obstet Gynaecol. 2003;43(6):473-4. https://doi.org/10.1046/j.0004-8666.2003.00132.x PMid:14712955 DOI: https://doi.org/10.1046/j.0004-8666.2003.00132.x

Ng TY, Wong LC. Diagnosis and management of gestational trophoblastic neoplasia. Best Pract Res Clin Obstet Gynaecol. 2003;17(6):893-903. https://doi.org/10.1016/s1521-6934(03)00098-1 PMid:14614888 DOI: https://doi.org/10.1016/S1521-6934(03)00098-1

Ngan H, Bender H, Benedet JL, Jones H, Montruccoli GC, Pecorelli S, et al. Gestational trophoblastic neoplasia, FIGO 2000 staging and classification. Int J Gynaecol Obstet. 2003;3 Suppl 1:175-7. https://doi.org/10.1016/s0020-7292(03)90120-2 PMid:14763174 DOI: https://doi.org/10.1016/S0020-7292(03)90120-2

Downloads

Published

2021-12-10

How to Cite

1.
Sastra Winata IG, Kusuardiyanto P, Aryana MBD, Mulyana R. Cervical Hydatidiform Moles Pregnancy: Diagnosis and Treatment. Open Access Maced J Med Sci [Internet]. 2021 Dec. 10 [cited 2024 Nov. 23];9(C):291-6. Available from: https://oamjms.eu/index.php/mjms/article/view/7562

Issue

Section

Case Reports in Gynecology and Obstetrics

Categories